ABSTRACT
HIV prevention programs are bedeviled by their own success. There is no praise for seroconversions that do not happen, for lives saved or communities protected. The reward for success is, rather, to be accused of scare-mongering, of demanding special treatment, of foisting a gay liberationist agenda in the guise of health promotion. As the high media profl1e of HIV lowers, as ring-fencing of funds is ended and as the contract culture of the new National Health Service allows the prejudice of managers to influence and perhaps override clinical judgments, we can expect to see many of the successes of the 19808 debilitated or destroyed. Resisting and challenging these changes is, ultimately, a question of political will. As we have suggested in Chapter 2, there is space in the chronicle of the 1980s for a little pride, some satisfaction, a few plaudits for the successes, insubstantial though they may sometimes seem in the greater devastation. The work ofProject SIGMA combines retrospect and prospect. On the one hand, we are able to show the success and the failures of HIV prevention policies and initiatives among gay and bisexual men. On the other, we seek to point to new directions, fresh challenges, emergent problems. We will not be alone in this, nor do we claim any greater right to dictate the future directions of policy than any other group. This fmal chapter we devote to a consideration of the fIndings we have outlined above and a series of suggestions for the future.
